August 20, 2018

Canada: The imminent departure of Saudi medical residents

Between 800 and 1000 medical residents from Saudi Arabia who currently work at Canadian hospitals will be forced to return home by the end of August. It's one consequence of a diplomatic dust-up between the kingdom and the Canadian government. It's going to have an impact on our healthcare system.

The residents are graduates of medical schools in Saudi Arabia who are doing postgraduate training at Canadian hospitals per a visa agreement between the two countries. A scholarship program set up by Saudi Arabia pays roughly $100,000 per trainee per year. In return, the Saudi graduates get to complete a high-quality residency training program in Canada in disciplines that include orthopedic surgery, internal medicine, obstetrics and gynecology, pediatrics and others.

Residents trained in Canada under the visa program are called 'supernumerary' residents, meaning their numbers are over and above the complement of residents who are principally graduates of Canadian medical schools. Still, they enhance Canada's healthcare system by taking care of patients at Canadian hospitals as part of their training.

Most if not every province is affected. There are 225 residents and fellows who work at McGill University Health Centre (MUHC), representing 20 per cent of the residents there. Two hundred and sixteen Saudi residents work at teaching hospitals in Toronto. Ninety-one residents work at London Health Sciences Centre. Ten are employed at hospitals in Windsor. More than 50 Saudi residents work at Dalhousie and other teaching hospitals in Nova Scotia. Forty-four residents and clinical fellows work at university-affiliated hospitals in B.C.

It's important to emphasize that only teaching hospitals are affected by the departure of Saudi residents. Non-teaching hospitals that do not employ residents are not impacted.

I've worked alongside Saudi residents in almost every discipline from orthopedics to internal medicine. This issue hit home during a shift in the ER last week. I saw a critically-ill patient who was suffering from severe shock from profound dehydration. I worked to save her life and then I referred her to the ICU team. A junior resident came to the ER supervised by a fellow from Saudi Arabia. The fellow provided service to my patient and was teaching the junior resident.

I went to the junior resident to say thanks for helping out. "He'll be gone in two weeks," she said with a look of despair.

Cancelled surgeries, overworked staff and more

That's just one story. In 2018, teaching hospitals have employed roughly 4,100 residents, 800 or more from Saudi Arabia. The departure of 800 or more of them means a sudden loss of 20 per cent of the residents. For teaching hospitals, it probably means cancelled surgeries and elective admissions to hospital. It also means the remaining 3,308 residents and probably some attending physicians and surgeons will be overworked, extra tired and sleep-deprived from picking up the slack.

I discussed this problem in a recent Tyee article. The Saudis aren't even especially sore at us over a tweet about their bad behaviour in Yemen; they're using us (and Canadian doctors and patients) as an example to critics elsewhere in the world. The Chinese call it "killing the chicken to scare the monkeys."

Comments

Between 800 and 1000 medical residents from Saudi Arabia who currently work at Canadian hospitals will be forced to return home by the end of August. It's one consequence of a diplomatic dust-up between the kingdom and the Canadian government. It's going to have an impact on our healthcare system.

The residents are graduates of medical schools in Saudi Arabia who are doing postgraduate training at Canadian hospitals per a visa agreement between the two countries. A scholarship program set up by Saudi Arabia pays roughly $100,000 per trainee per year. In return, the Saudi graduates get to complete a high-quality residency training program in Canada in disciplines that include orthopedic surgery, internal medicine, obstetrics and gynecology, pediatrics and others.

Residents trained in Canada under the visa program are called 'supernumerary' residents, meaning their numbers are over and above the complement of residents who are principally graduates of Canadian medical schools. Still, they enhance Canada's healthcare system by taking care of patients at Canadian hospitals as part of their training.

Most if not every province is affected. There are 225 residents and fellows who work at McGill University Health Centre (MUHC), representing 20 per cent of the residents there. Two hundred and sixteen Saudi residents work at teaching hospitals in Toronto. Ninety-one residents work at London Health Sciences Centre. Ten are employed at hospitals in Windsor. More than 50 Saudi residents work at Dalhousie and other teaching hospitals in Nova Scotia. Forty-four residents and clinical fellows work at university-affiliated hospitals in B.C.

It's important to emphasize that only teaching hospitals are affected by the departure of Saudi residents. Non-teaching hospitals that do not employ residents are not impacted.

I've worked alongside Saudi residents in almost every discipline from orthopedics to internal medicine. This issue hit home during a shift in the ER last week. I saw a critically-ill patient who was suffering from severe shock from profound dehydration. I worked to save her life and then I referred her to the ICU team. A junior resident came to the ER supervised by a fellow from Saudi Arabia. The fellow provided service to my patient and was teaching the junior resident.

I went to the junior resident to say thanks for helping out. "He'll be gone in two weeks," she said with a look of despair.

Cancelled surgeries, overworked staff and more

That's just one story. In 2018, teaching hospitals have employed roughly 4,100 residents, 800 or more from Saudi Arabia. The departure of 800 or more of them means a sudden loss of 20 per cent of the residents. For teaching hospitals, it probably means cancelled surgeries and elective admissions to hospital. It also means the remaining 3,308 residents and probably some attending physicians and surgeons will be overworked, extra tired and sleep-deprived from picking up the slack.

I discussed this problem in a recent Tyee article. The Saudis aren't even especially sore at us over a tweet about their bad behaviour in Yemen; they're using us (and Canadian doctors and patients) as an example to critics elsewhere in the world. The Chinese call it "killing the chicken to scare the monkeys."